Active NPI
Lauren Olivia Kelly, AUD
- Audiologist
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- Practice address
- 1611 W Harrison St Ste 530
Chicago, IL 60612-4861 - Phone
- (312) 942-5332
- NPI assigned
- Sep 17, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | Primary |
Addresses
Primary practice location
1611 W Harrison St Ste 530
Chicago, IL 60612-4861
Mailing address
2604 Dempster St Ste 501
Park Ridge, IL 60068-8429
Phone (847) 674-5585
Other practice location 1
8780 W Golf Rd Ste 200
Niles, IL 60714-5611
Phone (847) 824-4390
Other practice location 2
2604 Dempster St Ste 501
Park Ridge, IL 60068
Phone (847) 674-5585
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191217000853 | IL | Practitioner - Qualified Audiologist | 4587098041 | Reassigns benefits to 3 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Qualified Audiologist
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Rush University Medical Group
Practice addresses (Care Compare)
1611 W Harrison St
Suite 550
Chicago, IL 60612-4861
Phone (312) 942-6100
Hospital & facility affiliations
- Rush University Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ear, Nose & Throat Specialists of Illinois LTD | Current | Accepting new patients | |
| Rush University Medical Group | Current | Accepting new patients | |
| Midwest ENT Alliance PLLC | Current | Accepting new patients | |
| Bastian Voice Institute, LLC | Past | Accepting new patients |
Locations
75 Remittance Dr
Dept 1611
Chicago, IL 60675
1611 W Harrison St
Ste 550
Chicago, IL 60612
Phone (312) 563-4431
1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875
1611 W Harrison St
Ste 530
Chicago, IL 60612
Phone (312) 942-5332
3010 Highland Pkwy
Ste 550
Downers Grove, IL 60515
Phone (630) 724-1100
8780 W Golf Rd
Ste 200
Niles, IL 60714
Phone (847) 824-4390
2604 Dempster St
Ste 501
Park Ridge, IL 60068
Phone 8476745585111
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Otolaryngology Physician
- Downers Grove, IL
- NPI 1922122571
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568678400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736726400000",
"number": "1104476506",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2604 DEMPSTER ST STE 501",
"city": "PARK RIDGE",
"state": "IL",
"postal_code": "600688429",
"telephone_number": "847-674-5585"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1611 W HARRISON ST STE 530",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606124861",
"telephone_number": "312-942-5332"
}
],
"practiceLocations": [
{
"address_1": "8780 W Golf Rd Ste 200",
"address_purpose": "LOCATION",
"city": "Niles",
"state": "IL",
"postal_code": "607145611",
"country_code": "US",
"telephone_number": "847-824-4390",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2604 Dempster St Ste 501",
"address_purpose": "LOCATION",
"city": "Park Ridge",
"state": "IL",
"postal_code": "60068",
"country_code": "US",
"telephone_number": "847-674-5585",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KELLY",
"first_name": "LAUREN",
"middle_name": "OLIVIA",
"credential": "AUD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-17",
"last_updated": "2025-01-13",
"certification_date": "2025-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.